Wednesday, August 3, 2016

More children than ever
before are being diagnosed with autism
spectrum disorders (ASD). The U.S. Centers for Disease Control and Prevention
(CDC) now estimates that 1 in 68 eight year-old children has an ASD. This
dramatic increase in the prevalence of children with ASD over the past decade,
together with the clear benefits of early intervention, have created a need for
schools to identify children who may have an autism spectrum condition.
Understanding the differences between a medical diagnosis and an educational
determination of eligibility for special education services can help both
parents and professionals become better advocates.

The Individuals with
Disabilities Education Improvement Act of 2004 (IDEA) and the Diagnostic
and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are the two
major systems used to diagnose and classify children with ASD. The DSM-5 is
considered the primary authority in the fields of psychiatric and psychological
(clinical) diagnoses, while IDEA is the authority with regard to eligibility
decisions for special education. The DSM was developed by clinicians as a
diagnostic and classification system for both childhood and adult psychiatric
disorders. The IDEA is not a diagnostic system per se, but rather federal
legislation designed to ensure the appropriate education of children with
special educational needs in our public schools. Unlike the DSM-5, IDEA
specifies categories of ‘‘disabilities’’ to determine eligibility for special
educational services. The definitions of these categories (there are 13),
including autism, are the most widely used classification system in our
schools. According to IDEA regulations, the definition of autism is as follows:

(c)(1)(i) Autism means a
developmental disability significantly affecting verbal and nonverbal
communication and social interaction, generally evident before age 3, that
adversely affects a child’s educational performance. Other characteristics
often associated with autism are engagement in repetitive activities and
stereotyped movements, resistance to environmental change or change in daily
routines, and unusual responses to sensory experiences. The term does not apply
if a child’s educational performance is adversely affected primarily because
the child has an emotional disturbance, as defined in this section.

(ii) A child who manifests
the characteristics of ‘‘autism’’ after age 3 could be diagnosed as having
‘‘autism’’ if the criteria in paragraph (c)(1)(i) of this section are
satisfied.

This educational
definition is considered sufficiently broad and operationally acceptable to
accommodate both the clinical and educational descriptions of autism and related
disorders. While the DSM-5 diagnostic criteria are professionally helpful, they
are neither legally required nor sufficient for determining educational
placement. A medical diagnosis from a doctor or mental health professional
alone is not enough to qualify a child for special education services. It is
state and federal education codes and regulations (not DSM-5) that drive
classification and eligibility decisions. In fact, the National Research
Council (2001) recommends that all children identified with ASD, regardless of severity, be made eligible for special educational services under
the IDEA category of autism. Thus, school professionals must ensure that
children meet the criteria for autism as outlined by IDEA or state education
agency (SEA) and may use the DSM-5 to the extent that the diagnostic criteria
include the same core behaviors. All professionals, whether clinical or school,
should have the appropriate training and background related to the diagnosis
and treatment of neurodevelopmental disorders. The identification of autism
should be made by a professional team using multiple sources of information,
including, but not limited to an interdisciplinary assessment of social
behavior, language and communication, adaptive behavior, motor skills, sensory
issues, and cognitive functioning to help with intervention planning and
determining eligibility for special educational services.

Legal and special
education experts recommend the following guidelines to help school districts
meet the requirements for providing legally and educationally appropriate
programs and services to students who meet special education eligibility for
autism.

1. School districts should
ensure that the IEP process follows the procedural requirements of IDEA. This
includes actively involving parents in the IEP process and adhering to the time
frame requirements for assessment and developing and implementing the student’s
IEP. Moreover, parents must be notified of their due process rights. It’s
important to recognize that parent-professional communication and collaboration
are key components for making educational and program decisions.

2. School districts should
make certain that comprehensive, individualized evaluations are completed by
school professionals who have knowledge, experience, and expertise in ASD. If
qualified personnel are not available, school districts should provide the
appropriate training or retain the services of a consultant.

3. School districts should
develop IEPs based on the child’s unique pattern of strengths and weaknesses.
Goals for a child with ASD commonly include the areas of communication, social
behavior, adaptive skills, challenging behavior, and academic and functional
skills. The IEP must address appropriate instructional and curricular
modifications, together with related services such as counseling, occupational
therapy, speech/language therapy, physical therapy and transportation needs.
Evidence-based instructional strategies should also be adopted to ensure that
the IEP is implemented appropriately.

4. School districts should
assure that progress monitoring of students with ASD is completed at specified
intervals by an interdisciplinary team of professionals who have a knowledge
base and experience in autism. This includes collecting evidence-based data to
document progress towards achieving IEP goals and to assess program
effectiveness.

5. School districts should
make every effort to place students in integrated settings to maximize
interaction with non-disabled peers. Inclusion with typically developing
students is important for a child with ASD as peers provide the best models for
language and social skills. However, inclusive education alone is insufficient,
evidence-based intervention and training is also necessary to address specific
skill deficits. Although the least restrictive environment (LRE) provision of
IDEA requires that efforts be made to educate students with special needs in
less restrictive settings, IDEA also recognizes that some students may require
a more comprehensive program to provide FAPE.

6. School districts should
provide on-going training and education in ASD for both parents and
professionals. Professionals who are trained in specific methodology and
techniques will be most effective in providing the appropriate services and in
modifying curriculum based upon the unique needs of the individual child.

National Research Council
(2001). Educating children with autism. Committee on Educational Interventions
for Children with Autism. C. Lord & J. P. McGee (Eds). Division of
Behavioral and Social Sciences and Education. Washington, DC: NationalAcademy Press.

Twachtman-Cullen, D.,
& Twachtman-Bassett, J. (2011). The IEP from A to Z: How to create
meaningful and measurable goals and objectives. San Francisco, CA: Jossey-Bass.

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The objective of bestpracticeautism.com is to advocate, educate, and informby providing a best practice guide to the screening, assessment, and intervention for school-age children on the autism spectrum. Timely articles and postings include topics such as screening, evaluation, positive behavior support (PBS), self-management, educational planning, IEP development, gender differences, evidence-based interventions (EBI) and more. This site also features up-to-date information on scientifically validated treatment options for children with ASD and a list of best practice books, articles, and links to organizations. Designed to be a practical and useful resource, bestpracticeautism.com offers essential information for psychologists, teachers, counselors, advocates and attorneys, special education professionals, and parents.

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“It is rare that one book can pack so many resources and easy to digest information into a single volume! Families, school personnel, and professionals all need the extensive, and up-to-date tips, guides, and ‘must-knows’ provided here. It’s obvious the author is both a seasoned researcher and practitioner – a winning combination.” - Dr. Debra Moore, psychologist and co-author with Dr. Temple Grandin, of The Loving Push: How Parents & Professionals Can Help Spectrum Kids Become Successful Adult

“Dr Wilkinson has done it again. This updated and scholarly Second Edition reflects important recent changes regarding diagnosis and services for students with Autism Spectrum Disorder. With its numerous best-practice suggestions, it is a must-read for school psychologists, school social workers, and those who teach in general and special education.” - Dr Steven Landau, Professor of School Psychology in the Department of Psychology, Illinois State University

“This book is an essential resource for every educator that works with students with ASD! The easy-to-read format is complete with up to date research on evidence-based practices for this population, sample observation and assessment worksheets and case studies that allow the reader to apply the information presented.” - Gena P. Barnhill, PhD, NCSP, BCBA-D, LBA, Director of Special Education Programs at Lynchburg College, Lynchburg, VA

“As a parent-advocate, Dr. Wilkinson's book is both comprehensive and easy to digest. It's comprehensive because it provides readers with a 10,000 foot view of the landscape. It's easy to digest because it is written in language that non-professionals can understand. If you read only one book, this is the one.” - Dan Harris, JD

"The author does a wonderful job presenting all of the data, facts, figures and statistics in a very structured layout that is straightforward, practical and convenient to access. With the rising incidence of children being diagnosed on the Autism spectrum, this guide should be required reading for all direct service providers who work with children in the school setting. On behalf of the Autism community I extend a sincere thank you to Lee Wilkinson for this impressive and most valuable resource.” - ParentCoachingforAutism.com

“Dr. Wilkinson has created an outstanding blend of academic research and practical application in a text that is so clearly written it is a pleasure to read for professionals and parents alike. This book fills an important need that has existed for years. Dr. Wilkinson has created an indispensable resource that should definitely be in each school’s professional library.” - Ally4Autism.com

"The author has expertly formatted the book and each chapter so that the reader is provided with an excellent resource of recent and relevant information pertaining to screening, formal assessment, and interventions with individuals in this population.” - Canadian Journal of School Psychology

“The uses and limitations of a variety of methods from psychometrics to observational assessments are clearly presented. Case studies give the reader exemplars of a range of assessments and the implications for learning in a highly readable way. Key issues are provided in summary boxes. Interventions include a detailed guide to promote skills in self-monitoring in the learner. In summary, this is an accessible book, of benefit to all those involved in the assessment and support of students with ASD.” - Educational Psychology in Practice

"School district administrators, attorneys, educators, and psychologists will want to have this guide available to them as a resource on 'best practices' in the field of ASD." -Diane Adreon, Associate Director, University of Miami-Nova Southeastern University center for Autism and Related Disabilities (UM-NSU CARD)

"This book provides a complete source for parents, educators, researchers and clinicians seeking information related to assessment and interventions available for individuals (mostly children) diagnosed with Autism Spectrum Disorders (ASD). Parents will benefit from reading this book as it exposes variety of issues to consider when seeking assessment and treatment for their children." -Journal of Autism and Developmental Disorders

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